Drug interactions - summary-

Betablockers eg propranolol , doxycyline, estrogens 9 including oral contraceptives,)
felodipine, griseofluvin, nifedipine, phenylbutazone, quinidine, theophyline,
effects of the these drugs may be increased

Corticosteroids-
may enhance clearance of aspirin. sudden discontinuation ofcorticosteroids result in
salicylism. Effects of corticosteroids decreased

Insulin, oral diabetic agents-
Hypoglycemic efects increased

MAOI inhibitors-
may increase side effects

Methotrexate , 6-mercaptopurine-
bone marrow toxicity may occur

NSAIDs-
increased GI ulceration or bleeding may occur

Other  depressants-  ethanol, narcotics, general anesthetics, tranquilizers,
sedative-hypnotics-
increased drowsiness and CNS depressive effecs may occur

Sulfinpyrazone, probenecid-
uricosuric efects decreased

Tricylic antidepressant-
antidepressant levels. effects decrease

Warfarin
anticoagulant effects increased or decreased

Drug/Lab interactions-
Blood tests- serum amylase, fasting blood glucose, cholesterol, protein,
serum hepatic aminotranferase ALT uric acid, prothrobin time

Urine tests- glucose 5-hydroxyindoleaacetic acid, Gerhardt ketone, vanilayl mandelic acid ,
uric acid, diacetic acid, spectrophotometric detetion of barbiturates

Tension or muscle contraction headache

Adverse reactions-

Cardiovascular - tachycardia

CNS- drowsiness, dizziness, lightheadedness, confusion, mental depression,
unusual excitement , nervousness

Dermatologic- rash

GI- nausea, vomiting, flatulance, heartburn, abdominal pains, constipation

Hypersensitivity to salicylates

Special Precauitions-

Drug depndency - prolonged use may produce drug dependency ( psychologic
and pphysical toleace

Peptic ulcer, coagulation abnonramilties and preoperative states-
use with extreme cautionbecause of increased bleeding time

Reyes syndrome-
may occur in children, becuase of aspirin component . Do not use for chicken pox
or flu syndrome

Renal function impairment - use with caution because of decreased elimination

Hepatic impairment- use with caution because of decreased elimination

Pregnancy - use with caution

Lactation- undertermined

Children- safety and efficacy for use in children not established

Indication-
Tension or muscle contraction headache

Dosage-
Usual dosage is 1 to 2 capsules every 4 hours
Maximum  6 capsules /day

Children- 12 years of age and older -
see adult dosing

1. Caution patients that dependency .tolerance may result from long term use.

2. Tell patients to take food with food or full glass of water

3. Instruct patients not to discontinue after long-term regular use.

4. Caution patients to avoid intake of alcoholic beverages and other CNS with depressants
    without the the approval of their doctor.

5. Warn patients to avoid any hazardous activity (eg driving, smoking ) if dizziness, drowsiness,
   or decrease in mental  acuity occurs.

6. Advice patients to notify their doctor if any surgical procedures are required. Discontinue
   Aspirina ctivity 5 days prior to surgery to reduce potential for bleeding problems. 

7. Instruct patients not to take OTC medicines without consulting their doctor.

8. Advice patients to report any of the following symptoms to their doctor, eg, persistent or
    recurrent pain before next schedule dose, difficulty in breathing,buzzing at ears,
    increased drowsiness, vomiting, abdominal pain , tarry stools ,inusual bruising or bleeding.

To be  taken with  food or full glass of water

Pregnancy -
Use with caution

Lactation-
Undertermined

Children-
Safety and efficacy for use in children not established